微孢子虫感染导致角膜穿孔1例并文献复习  

Corneal perforation caused by microsporidia infection:a case report and literature review

作　　者：王玲 黎明[1,2] 应方微[1] 王玉 温文 姚晓明[1] WANG Ling;LI Ming;YING Fangwei;WANG Yu;WEN Wen;YAO Xiaoming(Shenzhen Eye Institute,Shenzhen Eye Hospital,Shenzhen 518040,Guangdong,China;Corneal Disease Department,Shenzhen Eye Hospital,Shenzhen 518040,Guangdong,China)

机构地区：[1]深圳市眼科医院眼病防治研究所,广东深圳518040 [2]深圳市眼科医院角膜病科,广东深圳518040

出　　处：《山东大学耳鼻喉眼学报》2024年第5期95-99,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：广东省高水平临床重点专科深圳市配套建设经费(SZGSP014)

摘　　要：目的探讨微孢子虫感染性角膜穿孔的诊疗方法,临床特点、诊断依据和研究进展。方法回顾性分析1例微孢子虫感染导致角膜穿孔患者的临床资料并复习相关文献进行总结。结果微孢子虫感染性角膜溃疡穿孔是罕见的眼部感染性疾病,传染途径暂不明确,可能与患者不洁手卫生史有关。角膜组织病检及荧光增白剂染色、宏基因组检测可确诊。在病程早期及时进行宏基因组检测对于尽早明确病原体类型、及时治疗用药具有关键性的指导作用。结论近年来,微孢子虫感染引起角膜疾病的病例越来越多,临床医生在诊断结膜炎相关的非典型点状上皮性角膜炎的过程中,应考虑微孢子虫感染的角膜结膜炎,避免发展为角膜穿孔,严重危及视力。Objective To investigate the diagnosis,treatment,clinical features,diagnostic principles,and research progress of corneal perforations caused by Microsporidia infection.Methods We retrospectively analyzed the clinical data of a patient with corneal perforation caused by Microsporidia infection and reviewed relevant literature.Results Microsporidial infection of corneal ulcer perforation is a rare infectious ocular disease.The transmission route is unclear but could be related to unclean hand hygiene.The diagnosis can be confirmed through corneal tissue examination,fluorescent whitening agent staining,and metagenomic detection.Early metagenomic detection during the disease course is crucial for the early identification of pathogen types and timely medication prescriptions.Conclusion In recent years,increased cases of Microsporidium keratoconjunctivitis have occurred in healthy individuals.Clinicians should consider Microsporidium keratoconjunctivitis in diagnosing conjunctivitis-related atypical punctate epithelial keratitis to avoid corneal perforation,which seriously endangers vision.

关 键 词：角膜溃疡 微孢子虫 Vittaforma corneae 角膜移植 宏基因组测序 

分 类 号：R770.4[医药卫生—眼科]